Will You Experience Menopause Like Your Mom?

Find out why your family history is important, but that's not all

My friend Susan recalls that during her high school years, her mother would quietly excuse herself from the dinner table, reappearing a few moments later wearing only her slip. "Nobody ever said a word about it, but in retrospect," Susan says, "I think it was a really classy way of handling her hot flashes." Her own approach? "I warn everyone within earshot by yelling, 'I'm flashing!'" Susan clearly inherited her mother's sense of humor, but are her own fiery hot flashes also a gift from her mom? Here's a guide to menopause across the generations.

Taking On the Taboo
For years, especially during the mid-1900s, menopausal women were treated as if they were losing both their desirability and their grip on reality. Ads for hormone treatments and "gentle daytime sedation" called middle-aged women names like "Unstable Mabel" and promised that drugs with a "low incidence of toxic reactions" would make them "pleasant to live with once again" and keep them "feminine forever." Menopause was "taboo, a hidden subject," says Christiane Northrup, MD, author of Mother-Daughter Wisdom: Understanding the Crucial Link Between Mothers, Daughters, and Health. A mother's experience with menopause has a huge impact on the way her daughter will feel about it, Dr. Northrup adds. "This is especially true when it comes to negative expectations about menopause." Minkin agrees: "Two women can have a similar experience and see it very differently," she says. "If the information—especially if it was limited—you got from your mom was very negative or very positive, it can certainly affect how you frame your own experience." If your mother is still alive, Dr. Minkin and Dr. Northrup recommend having a conversation with her about it—sort of a grownup version of the talk you may have had together when you reached puberty. No special script is necessary, Dr. Minkin says: "Just talk."

When, How and for What Length of Time?
The average age of natural menopause in the U.S. is about 51, and recent research from the Harvard School of Public Health indicates that there's some connection between the age at which your mother went through menopause and the age at which you will—especially if it was unusually early or late. "That's helpful if you need to know that you have a limited period of fertility," says Yale University's Mary Jane Minkin, MD, coauthor of A Woman's Guide to Menopause and Perimenopause. "But if your mom's menopause hit somewhere in the middle of that range, it doesn't tell you anything very useful about your own." Brynna, a mother of two, says her mother and two aunts went through menopause much earlier than the average. She wishes she'd made the genetic connection earlier, because her attempt to have a third child was unsuccessful. However, Dr. Minkin cautions, "There's a lot we don't know about the timing of menopause," she says. "Even within one family, each woman's menopause experience is going to be a little different."

Personal Effects
If your mom can't tell you what to expect, what can you do? Long-term hormone treatment may increase the risk of heart disease, stroke, blood clots and some cancers, but there are physicians who believe short-term hormone treatment (just a few years) can get you past the most bothersome symptoms. Synthetic hormones and herbal treatments are other options, but bear in mind that these medicines come with their own risks and side effects. Make sure your doctor is aware of your symptoms and your family medical history before he prescribes anything. Some treatments, though, are perfectly safe, and may well be the ones that helped your foremothers to get through their own change of life. Physicians agree that taking good care of yourself is key to feeling well throughout menopause.

Common Symptoms and Helpful Solutions

Hot flashes: Dress in easily removable layers during the day. At night, sleep on 100 percent cotton sheets and wear moisture-wicking pajamas. Keep a carafe of ice water on your nightstand. Avoid alcohol or spicy foods if they seem to turn up your personal thermostat. Try to maintain a healthy weight, too: Dr. Minkin notes that excess fat can make it difficult for your body to dissipate heat.

Sleep disturbances: First, see above. Doing what you can to alleviate the discomfort of hot flashes will help you sleep better. Daily exercise is also helpful, but not when it's close to bedtime. If all else fails, get up for a while and instant-message your girlfriends—they're probably awake, too!

Bone loss: A menopausal drop in estrogen can chip away at the density and strength of your bones. If you're over 51, your doctor will probably prescribe a daily supplement of 1,200 milligrams of calcium with vitamin D. If you're over 65 or at high risk for osteoporosis—most common in women who are Caucasian, of Southeast Asian descent, small-boned or have a family history of osteoporosis—your doctor will probably recommend a bone-density scan. Other helpful options include doing regular weight-bearing exercise and eating calcium-rich foods like dairy, calcium-fortified cereals and juices, salmon and dark leafy greens.

Emotional difficulty: Depression, anxiety and mood swings are classic hallmarks of menopause. Again, one treatment builds on another: Taking care of yourself by getting regular sleep, exercising and eating healthy can make a huge difference in your mood. Exercise can also keep you on an even keel, as can setting aside a few minutes a day for meditation, breathing exercises or creative outlets like journaling or painting.

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